What Repeal of the Individual Mandate Would Mean to Americans

The Republicans are at it again. The latest negotiations in the Senate on their tax bill have led them back to a proposal to eliminate the individual mandate under the Affordable Care Act. The lure of more than $300 billion in tax savings as calculated by the nonpartisan Congressional Budget Office (CBO) is too big a number for them to ignore, despite previous failed efforts at ACA repeal light. That same CBO predicts that the repeal would lead to 13 million fewer Americans with health insurance by 2027 and a 10% increase in premiums.

I am not an actuary, but really? Clearly the individual mandate is ineffective since, according to Gallup-Sharecare Well-Being Index, 11.7% of Americans were uninsured in the second quarter of 2017. Most of those who do have coverage receive subsidies through the ACA exchanges, their employers or a government entitlement program. I would guess that most of the others have coverage because they have a medical condition and need it. That’s why premiums on the individual marketplace have soared. So, I am not so sure that the ranks of insured would drop as precipitously as the CBO expects.

Some may call this good news for employers since some may experience a drop off in enrollment; employees would no longer face a penalty if they opt out of employer coverage. We didn’t really see much change with the mandate in place so I would expect this impact to be minor.

As for the 10% premium increase – that, I believe. Insurance companies will clearly use this as an excuse to increase premiums as much as they can – if they even stay in the game. The cards continue to get stacked against the insurance companies in the individual market. If I were at the table, I would fold.

Combining budget and healthcare is a big gamble for the GOP. The balancing act gets wobblier as the plates stack up and remember – with Senator Moore’s seat in play, the Republican majority is tenuous. The Trump effect may well wreak havoc in the midterm elections and then who knows?

Although only a small percentage of Americans are impacted by this healthcare chess game, the stakes are high. On Tuesday, Senate Republicans indicated that they would not support a bipartisan effort at incremental change. Call your Republican Senators and ask – why not? It’s time for stability.

About Craig Hasday

Craig Hasday is President of EPIC Northeast Benefits and President of Frenkel Benefits. As part of EPIC Insurance Brokers & Consultants (EPIC), Frenkel Benefits is one of the largest privately held independent employee benefits brokers in the United States.
Craig is a nationally recognized healthcare leader, who has sat on the national advisory boards of Aetna, UnitedHealthcare, Cigna and Anthem; as well as the regional advisory boards of most major carriers. He is currently on the MetLife and GeoBlue national advisory boards, is a legislative group member of the Council of Insurance Agents and Brokers and has been appointed to the MetLife National Broker & Consultant Summit. With current and former roles involved in lobbying and advisement on the legislative landscape, Craig is deeply engaged with the issues and intricacies surrounding healthcare delivery. He is an appointee to Governor Cuomo’s Regional Stakeholder Exchange Board and member of the NAHU Principals Council – as a liaison to the White House, U.S. Department of Health and Human Services (HHS), the U.S. Treasury and Congress – to advise on the practical issues associated with healthcare reform.
He has served as legislative chairperson for the New York State Association of Health Underwriters. Craig is also a former board member of the NAHU Education Foundation and has sat on the Global and Domestic Benefit Advisory Boards of Assurex Global. He is on the board of the NAHU Foundation and is a member of the UnitedHealthcare Children’s Foundation Regional Board of Directors.
Craig was honored with the International Benefits Network’s 2017 Service Excellence Award and selected as a 2015 Power Broker by Risk & Insurance Magazine. He is a frequent speaker on a broad array of issues affecting the insurance industry and is an adjunct professor in the New York University Masters of Human Capital Management Program.
Craig has appeared on CBS, NPR and other news programs as a healthcare commentator and is widely published and interviewed by the media as a benefits expert. As a judge for the 2014 and 2015 Business Insurance Benefit Manager of the Year awards, he contributes his benefits expertise toward selecting this prestigious award’s winner. Craig can be heard on WCBS Newsradio 880 during the daily business report speaking about healthcare and employer strategy in a segment titled, FrenkelySpeaking, which is based on the Frenkel Benefits’ blog.
Craig joined Frenkel in 1992, as the manager of what was then the Life & Employee Benefits department. Under his leadership, Frenkel Benefits has expanded almost twelvefold in revenue, now serving almost 800 clients across the U.S. and globally. Now together with EPIC, Frenkel Benefits is a significant contributor to EPIC’s benefits business.
Craig is a New York State CPA, formerly working in the New York office of a big-four accounting firm. He has experience as an audit and tax professional, chief financial officer and a small business owner. This diverse background brings an in-depth appreciation for the challenges facing clients.

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Please be aware that this does not represent legal or tax advice and is only Frenkel's interpretation of the laws, regulations and statutes. It is highly recommended that you seek the advice of your legal and tax professional as to the applicability of this information to your particular situation.